Study: Introducing propofol to ambulatory anesthesia may improve endoscopy quality metrics

Editor's Note

A study presented at the 2023 annual meeting of the Society for Ambulatory Anesthesia suggests that implementing ambulatory anesthesia services with propofol can significantly enhance various quality metrics in outpatient endoscopy procedures, Anesthesiology News August 28 reports. The study, led by Justin Routman, MD, director of non-OR anesthesia at the University of Alabama at Birmingham, aimed to improve operational efficiency and safety by replacing nurse-administered sedation with monitored anesthesia care (MAC).

Key findings from the study, which focused on an outpatient endoscopy center at a tertiary medical center, include:

• 33% increase in the number of procedures performed per physician
• 40% decrease in delayed cases
• 18% reduction in aborted or incomplete procedures
• 93% reduction in cases aborted due to inadequate sedation
• 50% reduction in post-procedure returns to the hospital.

According to the study, the above findings indicate that the introduction of ambulatory anesthesia services not only boosted efficiency but also enhanced patient safety. Dr Routman emphasized that this approach allowed anesthesia teams to focus solely on patient care and safety while endoscopy teams concentrated on performing procedures diligently.

However, the study noted limitations, including a small number of patient prep/recovery bays. Future research may address questions related to the use of MAC for these procedures, including evaluating the return-on-investment and revenue streams from anesthesia billing, particularly for smaller institutions. Additionally, studies assessing provider satisfaction and engagement among endoscopist physicians may provide further insights.